Alpenrose Dinner-Dance Reservation Form
Weihnachtstanz Valencia Ballroom December 20, 2009(
New Date January 24, 2010 ) Doors open at 12:30 NoonDinner at 12:30 PM. Dancing .2 PM. to 6 PM.
I plan to attend the dinner-dance with _______ Members @ $28.00 each, Total________
_______ Guests @ $35.00 each Total________
Grand Total________
Name_____________________________________ Telephone ( )_______________
Address____________________________ City/State________________ _Zip________
Talk it over with whom you want to sit, ( It would be a great help) than let us know who is on your table, (tables of eight)
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This form with your payment should be returned to Edie Heindel 2106 Hershey Ct. York PA. 17404-1768 by no later than December 2, 2009 (New Deadline January 14, 2010). Please no exceptions. Please no refunds after Deadline Make checks payable to (Alpenrose )
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Separate here and pay separately_________________________________ Alpenrose Membership Renewal FormPlease renew ( my ) ( our ) membership to the German-American Society ( Alpenrose ) for 2010. Adult dues are $15.00 per year. Youth dues for 6 year olds through college are $7.50. The Deadline is March 31, 2010.
Please complete the information requested below.
Name: 1._________________________________________Name 2______________________________________
Street______________________________________________________________________________________
City:________________________State:__________________________Zip:_________________Telephone ( )________________
Send completed form and check payable to ( Alpenrose ) and a self-addressed, stamped envelope to [ Al. Langis 12 Culpepper Rd. Shrewsbury, Pa. 17361 ]
Date rec’d_____________________________ 2009Card no. ___________________
Optional: Birthday 1.___________________ Anniversary:_______________________
Birthday 2. __________________ E-Mail:______________________________